Spatiotemporal Measurement of Arterial Pulse Waves Enabled by Wearable Active-Matrix Pressure Sensor Arrays

Traditional Chinese Medicine (TCM)-Inspired Fully Printed Soft Pressure Sensor Array with Self-Adaptive Pressurization for Highly Reliable Individualized Long-Term Pulse Diagnostics

Reliable, non-invasive, continuous monitoring of pulse and blood pressure is essential for the prevention and diagnosis of cardiovascular diseases. However, the pulse wave varies drastically among individuals or even over time in the same individual, presenting significant challenges for the existing pulse sensing systems. Inspired by pulse diagnosis methods in traditional Chinese medicine (TCM), this work reports a self-adaptive pressure sensing platform (PSP) that combines the fully printed flexible pressure sensor array with an adaptive wristband-style pressure system can identify the optimal pulse signal. Besides the detected pulse rate/width/length, "Cun, Guan, Chi" position, and "floating, moderate, sinking" pulse features, the PSP combined with a machine learning-based linear regression model can also accurately predict blood pressure such as systolic, diastolic, and mean arterial pressure values. The developed diagnostic platform is demonstrated for highly reliable long-term monitoring and analysis of pulse and blood pressure across multiple human subjects over time. The design concept and proof-of-the-concept demonstrations also pave the way for the future developments of flexible sensing devices/systems for adaptive individualized monitoring in the complex practical environments for personalized medicine, along with the support for the development of digital TCM.

Harsh Environment-Tolerant, High Performance Soft Pressure Sensors Enabled by Fiber-Segment Structure and Plasma Treatment

As the demand for specialized and diversified pressure sensors continues to increase, excellent performance and multi-applicability have become necessary for pressure sensors. Currently, flexible pressure sensors are primarily utilized in fields such as health monitoring and human-computer interaction. However, numerous complex extreme environments in reality, including deep sea, corrosive conditions, extreme cold, and high temperatures, urgently require the services of flexible devices. Here, a piezoresistive flexible pressure sensor based on expanded polytetrafluoroethylene/functionalized carbon nanotubes (EPTFE/FCNT) is proposed. Benefiting from the unique fiber-segment architecture, chemical stability, and strong chemical binding force between EPTFE and FCNT, the fabricated sensor exhibits remarkable sensing capabilities and can be employed in multifarious extreme environments. It demonstrates a sensitivity of 862.28 kPa-1, a response time of 6-7 ms, and a detection limit below 1 Pa. Furthermore, it possesses a pressure resolution of 0.0018% under 111 kPa and can withstand over 10,000 loading and unloading cycles under 1 MPa. Additionally, the EPTFE/FCNT sensor retains its outstanding pressure response and work efficiency in extreme conditions such as an ultra-low temperature of -80 °C, high temperature (200 °C), acidic and alkaline corrosion, and underwater. These notable attributes enormously broaden the sensors' real-world application range.

Dynamic monitoring of a 3D-printed airway tissue model using an organic electrochemical transistor

Assessing the transepithelial resistance to ion flow in the presence of an electric field enables the evaluation of the integrity of the epithelial cell layer. In this study, we introduce an organic electrochemical transistor (OECT) interfaced with a 3D living tissue, designed to monitor the electrical resistance of cellular barriers in real-time. We have developed a non-invasive, tissue-sensing platform by integrating an inkjet-printed large-area OECT with a 3D-bioprinted multilayered airway tissue. This unique configuration enables the evaluation of epithelial barrier integrity through the dynamic response capabilities of the OECT. Our system effectively tracks the formation and integrity of 3D-printed airway tissues in both liquid-liquid and air-liquid interface culture environments. Furthermore, we successfully quantified the degradation of barrier function due to influenza A (H1N1) viral infection and the dose-dependent efficacy of oseltamivir (Tamiflu®) in mitigating this degradation. The tissue-electronic platform offers a non-invasive and label-free method for real-time monitoring of 3D artificial tissue barriers, without disturbing the cellular biology. It holds the potential for further applications in monitoring the structures and functions of 3D tissues and organs, significantly contributing to the advancement of personalized medicine.

Blade-Coated Porous 3D Carbon Composite Electrodes Coupled with Multiscale Interfaces for Highly Sensitive All-Paper Pressure Sensors

Flexible and wearable pressure sensors hold immense promise for health monitoring, covering disease detection and postoperative rehabilitation. Developing pressure sensors with high sensitivity, wide detection range, and cost-effectiveness is paramount. By leveraging paper for its sustainability, biocompatibility, and inherent porous structure, herein, a solution-processed all-paper resistive pressure sensor is designed with outstanding performance. A ternary composite paste, comprising a compressible 3D carbon skeleton, conductive polymer poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate), and cohesive carbon nanotubes, is blade-coated on paper and naturally dried to form the porous composite electrode with hierachical micro- and nano-structured surface. Combined with screen-printed Cu electrodes in submillimeter finger widths on rough paper, this creates a multiscale hierarchical contact interface between electrodes, significantly enhancing sensitivity (1014 kPa-1) and expanding the detection range (up to 300 kPa) of as-resulted all-paper pressure sensor with low detection limit and power consumption. Its versatility ranges from subtle wrist pulses, robust finger taps, to large-area spatial force detection, highlighting its intricate submillimeter-micrometer-nanometer hierarchical interface and nanometer porosity in the composite electrode. Ultimately, this all-paper resistive pressure sensor, with its superior sensing capabilities, large-scale fabrication potential, and cost-effectiveness, paves the way for next-generation wearable electronics, ushering in an era of advanced, sustainable technological solutions.

In-Sensor Tactile Fusion and Logic for Accurate Intention Recognition

Touch control intention recognition is an important direction for the future development of human-machine interactions (HMIs). However, the implementation of parallel-sensing functional modules generally requires a combination of different logical blocks and control circuits, which results in regional redundancy, redundant data, and low efficiency. Here, a location-and-pressure intelligent tactile sensor (LPI tactile sensor) unprecedentedly combined with sensing, computing, and logic is proposed, enabling efficient and ultrahigh-resolution action-intention interaction. The LPI tactile sensor eliminates the need for data transfer among the functional units through the core integration design of the layered structure. It actuates in-sensor perception through feature transmission, fusion, and differentiation, thereby revolutionizing the traditional von Neumann architecture. While greatly simplifying the data dimensionality, the LPI tactile sensor achieves outstanding resolution sensing in both location (<400 µm) and pressure (75 Pa). Synchronous feature fusion and decoding support the high-fidelity recognition of action and combinatorial logic intentions. Benefiting from location and pressure synergy, the LPI tactile sensor demonstrates robust privacy as an encrypted password device and interaction intelligence through pressure enhancement. It can recognize continuous touch actions in real time, map real intentions to target events, and promote accurate and efficient intention-driven HMIs.

Ag-thiolate interactions to enable an ultrasensitive and stretchable MXene strain sensor with high temporospatial resolution

High-sensitivity strain sensing elements with a wide strain range, fast response, high stability, and small sensing areas are desirable for constructing strain sensor arrays with high temporospatial resolution. However, current strain sensors rely on crack-based conductive materials having an inherent tradeoff between their sensing area and performance. Here, we present a molecular-level crack modulation strategy in which we use layer-by-layer assembly to introduce strong, dynamic, and reversible coordination bonds in an MXene and silver nanowire-matrixed conductive film. We use this approach to fabricate a crack-based stretchable strain sensor with a very small sensing area (0.25 mm2). It also exhibits an ultrawide working strain range (0.001-37%), high sensitivity (gauge factor ~500 at 0.001% and >150,000 at 35%), fast response time, low hysteresis, and excellent long-term stability. Based on this high-performance sensing element and facile assembly process, a stretchable strain sensor array with a device density of 100 sensors per cm2 is realized. We demonstrate the practical use of the high-density strain sensor array as a multichannel pulse sensing system for monitoring pulses in terms of their spatiotemporal resolution.

Wearable multichannel-active pressurized pulse sensing platform

With the modernization of traditional Chinese medicine (TCM), creating devices to digitalize aspects of pulse diagnosis has proved to be challenging. The currently available pulse detection devices usually rely on external pressure devices, which are either bulky or poorly integrated, hindering their practical application. In this work, we propose an innovative wearable active pressure three-channel pulse monitoring device based on TCM pulse diagnosis methods. It combines a flexible pressure sensor array, flexible airbag array, active pressure control unit, advanced machine learning approach, and a companion mobile application for human-computer interaction. Due to the high sensitivity (460.1 kPa-1), high linearity (R 2 > 0.999) and flexibility of the flexible pressure sensors, the device can accurately simulate finger pressure to collect pulse waves (Cun, Guan, and Chi) at different external pressures on the wrist. In addition, by measuring the change in pulse wave amplitude at different pressures, an individual's blood pressure status can be successfully predicted. This enables truly wearable, actively pressurized, continuous wireless dynamic monitoring of wrist pulse health. The innovative and integrated design of this pulse monitoring platform could provide a new paradigm for digitizing aspects of TCM and other smart healthcare systems.

Soft mechanical sensors for wearable and implantable applications

Wearable and implantable sensing of biomechanical signals such as pressure, strain, shear, and vibration can enable a multitude of human-integrated applications, including on-skin monitoring of vital signs, motion tracking, monitoring of internal organ condition, restoration of lost/impaired mechanoreception, among many others. The mechanical conformability of such sensors to the human skin and tissue is critical to enhancing their biocompatibility and sensing accuracy. As such, in the recent decade, significant efforts have been made in the development of soft mechanical sensors. To satisfy the requirements of different wearable and implantable applications, such sensors have been imparted with various additional properties to make them better suited for the varied contexts of human-integrated applications. In this review, focusing on the four major types of soft mechanical sensors for pressure, strain, shear, and vibration, we discussed the recent material and device design innovations for achieving several important properties, including flexibility and stretchability, bioresorbability and biodegradability, self-healing properties, breathability, transparency, wireless communication capabilities, and high-density integration. We then went on to discuss the current research state of the use of such novel soft mechanical sensors in wearable and implantable applications, based on which future research needs were further discussed. This article is categorized under: Diagnostic Tools > Biosensing Diagnostic Tools > Diagnostic Nanodevices Implantable Materials and Surgical Technologies > Nanomaterials and Implants.

Unleashing inkjet-printed nanostructured electrodes and battery-free potentiostat for the DNA-based multiplexed detection of SARS-CoV-2 genes

Following the global COVID-19 pandemic triggered by SARS-CoV-2, the need for rapid, specific and cost-effective point-of-care diagnostic solutions remains paramount. Even though COVID-19 is no longer a public health emergency, the disease still poses a global threat leading to deaths, and it continues to change with the risk of new variants emerging causing a new surge in cases and deaths. Here, we address the urgent need for rapid, cost-effective and point-of-care diagnostic solutions for SARS-CoV-2. We propose a multiplexed DNA-based sensing platform that utilizes inkjet-printed nanostructured gold electrodes and an inkjet-printed battery-free near-field communication (NFC) potentiostat for the simultaneous quantitative detection of two SARS-CoV-2 genes, the ORF1ab and the N gene. The detection strategy based on the formation of an RNA-DNA sandwich structure leads to a highly specific electrochemical output. The inkjet-printed nanostructured gold electrodes providing a large surface area enable efficient binding and increase the sensitivity. The inkjet-printed battery-free NFC potentiostat enables rapid measurements and real-time data analysis via a smartphone application, making the platform accessible and portable. With the advantages of speed (5 min), simplicity, sensitivity (low pM range, ∼450% signal gain) and cost-effectiveness, the proposed platform is a promising alternative for point-of-care diagnostics and high-throughput analysis that complements the COVID-19 diagnostic toolkit.

Multi-Level Pyramidal Microstructure-Based Pressure Sensors with High Sensitivity and Wide Linear Range for Healthcare Monitoring

Flexible pressure sensors have garnered significant attention in the field of wearable healthcare due to their scalability and shape variability. However, a crucial challenge in their practical application for various healthcare scenarios is striking a balance between the sensitivity and sensing range. This limitation arises from the reduced compressibility of the microstructures on the surface of pressure-sensitive materials under high pressure, resulting in progressive saturation of the sensor's response and leading to a restricted and nonlinear pressure sensing range. In this study, we present a novel approach utilizing multi-level pyramidal microstructures in flexible pressure sensors to achieve both high sensitivity (8775 kPa-1) and linear response (R2 = 0.997) over a wide pressure range (up to 1000 kPa). The effectiveness of the proposed design stems from the compensatory behavior of the lower pyramidal microstructures, which counteracts the declining sensitivity associated with the gradual hardening of the higher pyramidal microstructures. Furthermore, the sensor demonstrates a fast response time of 11.6 ms and a fast relaxation time of 3.8 ms and can reliably detect pressures as low as 30.2 Pa. Our findings highlight the applicability of this flexible pressure sensor in diverse human body health detection tasks, ranging from weak pulses to finger flexion and plantar pressure distribution. Notably, the proposed sensor design eliminates the need for replacing flexible pressure sensors with varying ranges, thereby enhancing their practical utility.

A Novel Resistive Sensor Network Utilizing an SAP-Enhanced Ionic Layer and CNT Doping for Multipoint Pressure Measurement

Amidst the rapid advancements in flexible electronics, flexible pressure sensors have achieved widespread applications in fields such as wearable devices and motion monitoring. Nevertheless, it is still a challenge to design a sensor with high sensitivity, cost-effectiveness, and a simplified manufacturing process. This paper introduces a piezoresistive sensor built upon a composite conductive filler. The sensor incorporates a super absorbent polymer (SAP) to absorb a phosphoric acid solution and doped carbon nanotubes as the composite conductive filler. In contrast to conventional rigid conductive fillers, the elastic polymer SAP enhances the sensor's stability significantly by exhibiting superior compatibility with the polydimethylsiloxane matrix, all the while reducing its Young's modulus. This work aims to theoretically elucidate the underlying principles that enable the sensor to achieve high sensitivity. It focuses on the induction of charge carriers due to pressure, which leads to the formation of a conductive pathway and subsequent changes in resistance, thus facilitating precise pressure detection. The paper also discusses the effects of piezoresistive layers with varying thicknesses and conductive fillers on the sensor's output performance. The results highlight the sensor's high sensitivity (0.094 kPa-1), rapid response time (105 ms), and exceptional cyclic load/unload stability (>5000 cycles). Furthermore, this paper establishes a versatile sensing network by integrating a portable inductance, capacitance, and resistance instrument with a programmable logic controller module. Compared to individual sensors, this system enables multipoint measurements, offering high spatial resolution and real-time monitoring capabilities, significantly expanding its overall practicality.

Recent Advances of Nanogenerator Technology for Cardiovascular Sensing and Monitoring

Cardiovascular sensing and monitoring is a widely used function in cardiovascular devices. Nowadays, achieving desired flexibility, wearability and implantability becomes a major design goal for the advancement of this family of devices. As an emerging technology, nanogenerator (NG) offers an intriguing promise for replacing the battery, an essential obstacle toward tissue-like soft electronics. This article reviews most recent advancements in NG technology for advanced cardiovascular sensing and monitoring. Based on the application targets, the discuss covers implantable NGs on hearts, implantable NGs for blood vessel grafts and patches, and wearable NGs with various sensing functions. The applications of NGs as a power source and as an electromechanical sensing element are both discussed. At the end, current challenges in this direction and future research perspectives are elaborated. This emerging and impactful application direction reviewed in this article is expected to inspire many new research and commercialization opportunities in the field of NG technology.

Scalable Manufacturing of Large-Area Pressure Sensor Array for Sitting Posture Recognition in Real Time

Pressure sensors are considered the key technology for potential applications in real-time health monitoring, artificial electronic skins, and human-machine interfaces. Despite the significant progress in developing novel sensitive materials and constructing unique sensor structures, it remains challenging to fabricate large-area pressure sensor arrays due to the involvement of complex procedures including photolithography, laser writing, or coating. Herein, a scalable manufacturing approach for the realization of pressure sensor arrays with substantially enlarged sensitive areas is proposed using a versatile screen-printing technique. A compensation mechanism is introduced into the printing process to ensure the precise alignment of conductive electrodes, insulation layers, and sensitive microstructures with an alignment error of less than 4 μm. The fully screen-printed sensors exhibit excellent collective sensing performance, such as a reasonable pressure sensitivity of -2.2 kPa-1, a fast response time of 40 ms, and superior durability over 3000 consecutive pressures. Additionally, an integrated 16 × 32 pressure sensor array with a sensing area of 190 × 380 mm2 is demonstrated to precisely recognize the sitting postures and the body weights, showing great potential in continuous and real-time health status monitoring.

Fabrication of Eco-Friendly Wearable Strain Sensor Arrays via Facile Contact Printing for Healthcare Applications

Wearable flexible strain sensors with spatial resolution enable the acquisition and analysis of complex actions for noninvasive personalized healthcare applications. To provide secure contact with skin and to avoid environmental pollution after usage, sensors with biocompatibility and biodegradability are highly desirable. Herein, wearable flexible strain sensors composed of crosslinked gold nanoparticle (GNP) thin films as the active conductive layer and transparent biodegradable polyurethane (PU) films as the flexible substrate are developed. The patterned GNP films (micrometer- to millimeter-scale square and rectangle geometry, alphabetic characters, and wave and array patterns) are transferred onto the biodegradable PU film via a facile, clean, rapid and high-precision contact printing method, without the need of a sacrificial polymer carrier or organic solvents. The GNP-PU strain sensor with low Young's modulus (≈17.8 MPa) and high stretchability showed good stability and durability (10 000 cycles) as well as degradability (42% weight loss after 17 days at 74 °C in water). The GNP-PU strain sensor arrays with spatiotemporal strain resolution are applied as wearable eco-friendly electronics for monitoring subtle physiological signals (e.g., mapping of arterial lines and sensing pulse waveforms) and large-strain actions (e.g., finger bending).

Recent Advances in Flexible Piezoresistive Arrays: Materials, Design, and Applications

Spatial distribution perception has become an important trend for flexible pressure sensors, which endows wearable health devices, bionic robots, and human-machine interactive interfaces (HMI) with more precise tactile perception capabilities. Flexible pressure sensor arrays can monitor and extract abundant health information to assist in medical detection and diagnosis. Bionic robots and HMI with higher tactile perception abilities will maximize the freedom of human hands. Flexible arrays based on piezoresistive mechanisms have been extensively researched due to the high performance of pressure-sensing properties and simple readout principles. This review summarizes multiple considerations in the design of flexible piezoresistive arrays and recent advances in their development. First, frequently used piezoresistive materials and microstructures are introduced in which various strategies to improve sensor performance are presented. Second, pressure sensor arrays with spatial distribution perception capability are discussed emphatically. Crosstalk is a particular concern for sensor arrays, where mechanical and electrical sources of crosstalk issues and the corresponding solutions are highlighted. Third, several processing methods are also introduced, classified as printing, field-assisted and laser-assisted fabrication. Next, the representative application works of flexible piezoresistive arrays are provided, including human-interactive systems, healthcare devices, and some other scenarios. Finally, outlooks on the development of piezoresistive arrays are given.

A Review of Epidermal Flexible Pressure Sensing Arrays

In recent years, flexible pressure sensing arrays applied in medical monitoring, human-machine interaction, and the Internet of Things have received a lot of attention for their excellent performance. Epidermal sensing arrays can enable the sensing of physiological information, pressure, and other information such as haptics, providing new avenues for the development of wearable devices. This paper reviews the recent research progress on epidermal flexible pressure sensing arrays. Firstly, the fantastic performance materials currently used to prepare flexible pressure sensing arrays are outlined in terms of substrate layer, electrode layer, and sensitive layer. In addition, the general fabrication processes of the materials are summarized, including three-dimensional (3D) printing, screen printing, and laser engraving. Subsequently, the electrode layer structures and sensitive layer microstructures used to further improve the performance design of sensing arrays are discussed based on the limitations of the materials. Furthermore, we present recent advances in the application of fantastic-performance epidermal flexible pressure sensing arrays and their integration with back-end circuits. Finally, the potential challenges and development prospects of flexible pressure sensing arrays are discussed in a comprehensive manner.

Physics-informed neural networks for modeling physiological time series for cuffless blood pressure estimation

The bold vision of AI-driven pervasive physiological monitoring, through the proliferation of off-the-shelf wearables that began a decade ago, has created immense opportunities to extract actionable information for precision medicine. These AI algorithms model input-output relationships of a system that, in many cases, exhibits complex nature and personalization requirements. A particular example is cuffless blood pressure estimation using wearable bioimpedance. However, these algorithms need training over significant amount of ground truth data. In the context of biomedical applications, collecting ground truth data, particularly at the personalized level is challenging, burdensome, and in some cases infeasible. Our objective is to establish physics-informed neural network (PINN) models for physiological time series data that would use minimal ground truth information to extract complex cardiovascular information. We achieve this by building Taylor's approximation for gradually changing known cardiovascular relationships between input and output (e.g., sensor measurements to blood pressure) and incorporating this approximation into our proposed neural network training. The effectiveness of the framework is demonstrated through a case study: continuous cuffless BP estimation from time series bioimpedance data. We show that by using PINNs over the state-of-the-art time series models tested on the same datasets, we retain high correlations (systolic: 0.90, diastolic: 0.89) and low error (systolic: 1.3 ± 7.6 mmHg, diastolic: 0.6 ± 6.4 mmHg) while reducing the amount of ground truth training data on average by a factor of 15. This could be helpful in developing future AI algorithms to help interpret pervasive physiologic data using minimal amount of training data.

Boron nitride-enabled printing of a highly sensitive and flexible iontronic pressure sensing system for spatial mapping

Recently, flexible iontronic pressure sensors (FIPSs) with higher sensitivities and wider sensing ranges than conventional capacitive sensors have been widely investigated. Due to the difficulty of fabricating the nanostructures that are commonly used on electrodes and ionic layers by screen printing techniques, strategies for fabricating such devices using these techniques to drive their mass production have rarely been reported. Herein, for the first time, we employed a 2-dimensional (2D) hexagonal boron nitride (h-BN) as both an additive and an ionic liquid reservoir in an ionic film, making the sensor printable and significantly improving its sensitivity and sensing range through screen printing. The engineered sensor exhibited high sensitivity (Smin> 261.4 kPa-1) and a broad sensing range (0.05-450 kPa), and it was capable of stable operation at a high pressure (400 kPa) for more than 5000 cycles. In addition, the integrated sensor array system allowed accurate monitoring of wrist pressure and showed great potential for health care systems. We believe that using h-BN as an additive in an ionic material for screen-printed FIPS could greatly inspire research on 2D materials for similar systems and other types of sensors. Hexagonal boron nitride (h-BN) was employed for the first time to make iontronic pressure sensor arrays with high sensitivity and a broad sensing range by screen printing.

Electronic textiles: New age of wearable technology for healthcare and fitness solutions

Sedentary lifestyles and evolving work environments have created challenges for global health and cause huge burdens on healthcare and fitness systems. Physical immobility and functional losses due to aging are two main reasons for noncommunicable disease mortality. Smart electronic textiles (e-textiles) have attracted considerable attention because of their potential uses in health monitoring, rehabilitation, and training assessment applications. Interactive textiles integrated with electronic devices and algorithms can be used to gather, process, and digitize data on human body motion in real time for purposes such as electrotherapy, improving blood circulation, and promoting wound healing. This review summarizes research advances on e-textiles designed for wearable healthcare and fitness systems. The significance of e-textiles, key applications, and future demand expectations are addressed in this review. Various health conditions and fitness problems and possible solutions involving the use of multifunctional interactive garments are discussed. A brief discussion of essential materials and basic procedures used to fabricate wearable e-textiles are included. Finally, the current challenges, possible solutions, opportunities, and future perspectives in the area of smart textiles are discussed.

Technology Roadmap for Flexible Sensors

Humans rely increasingly on sensors to address grand challenges and to improve quality of life in the era of digitalization and big data. For ubiquitous sensing, flexible sensors are developed to overcome the limitations of conventional rigid counterparts. Despite rapid advancement in bench-side research over the last decade, the market adoption of flexible sensors remains limited. To ease and to expedite their deployment, here, we identify bottlenecks hindering the maturation of flexible sensors and propose promising solutions. We first analyze challenges in achieving satisfactory sensing performance for real-world applications and then summarize issues in compatible sensor-biology interfaces, followed by brief discussions on powering and connecting sensor networks. Issues en route to commercialization and for sustainable growth of the sector are also analyzed, highlighting environmental concerns and emphasizing nontechnical issues such as business, regulatory, and ethical considerations. Additionally, we look at future intelligent flexible sensors. In proposing a comprehensive roadmap, we hope to steer research efforts towards common goals and to guide coordinated development strategies from disparate communities. Through such collaborative efforts, scientific breakthroughs can be made sooner and capitalized for the betterment of humanity.

Emerging MXene-Based Flexible Tactile Sensors for Health Monitoring and Haptic Perception

Due to their potential applications in physiological monitoring, diagnosis, human prosthetics, haptic perception, and human-machine interaction, flexible tactile sensors have attracted wide research interest in recent years. Thanks to the advances in material engineering, high performance flexible tactile sensors have been obtained. Among the representative pressure sensing materials, 2D layered nanomaterials have many properties that are superior to those of bulk nanomaterials and are more suitable for high performance flexible sensors. As a class of 2D inorganic compounds in materials science, MXene has excellent electrical, mechanical, and biological compatibility. MXene-based composites have proven to be promising candidates for flexible tactile sensors due to their excellent stretchability and metallic conductivity. Therefore, great efforts have been devoted to the development of MXene-based composites for flexible sensor applications. In this paper, the controllable preparation and characterization of MXene are introduced. Then, the recent progresses on fabrication strategies, operating mechanisms, and device performance of MXene composite-based flexible tactile sensors, including flexible piezoresistive sensors, capacitive sensors, piezoelectric sensors, triboelectric sensors are reviewed. After that, the applications of MXene material-based flexible electronics in human motion monitoring, healthcare, prosthetics, and artificial intelligence are discussed. Finally, the challenges and perspectives for MXene-based tactile sensors are summarized.

Dual-gate thin film transistor lactate sensors operating in the subthreshold regime

Organic thin-film transistors (TFTs) with an electrochemically functionalized sensing gate are promising platforms for wearable health-monitoring technologies because they are light, flexible, and cheap. Achieving both high sensitivity and low power is highly demanding for portable or wearable devices. In this work, we present flexible printed dual-gate (DG) organic TFTs operating in the subthreshold regime with ultralow power and high sensitivity. The subthreshold operation of the gate-modulated TFT-based sensors not only increases the sensitivity but also reduces the power consumption. The DG configuration has deeper depletion and stronger accumulation, thereby further making the subthreshold slope sharper. We integrate an enzymatic lactate-sensing extended-gate electrode into the printed DG TFT and achieve exceptionally high sensitivity (0.77) and ultralow static power consumption (10 nW). Our sensors are successfully demonstrated in physiological lactate monitoring with human saliva. The accuracy of the DG TFT sensing system is as good as that of a high-cost conventional assay. The developed platform can be readily extended to various materials and technologies for high performance wearable sensing applications.

Conjugated Polymer-Based Nanocomposites for Pressure Sensors

Flexible sensors are the essential foundations of pressure sensing, microcomputer sensing systems, and wearable devices. The flexible tactile sensor can sense stimuli by converting external forces into electrical signals. The electrical signals are transmitted to a computer processing system for analysis, realizing real-time health monitoring and human motion detection. According to the working mechanism, tactile sensors are mainly divided into four types-piezoresistive, capacitive, piezoelectric, and triboelectric tactile sensors. Conventional silicon-based tactile sensors are often inadequate for flexible electronics due to their limited mechanical flexibility. In comparison, polymeric nanocomposites are flexible and stretchable, which makes them excellent candidates for flexible and wearable tactile sensors. Among the promising polymers, conjugated polymers (CPs), due to their unique chemical structures and electronic properties that contribute to their high electrical and mechanical conductivity, show great potential for flexible sensors and wearable devices. In this paper, we first introduce the parameters of pressure sensors. Then, we describe the operating principles of resistive, capacitive, piezoelectric, and triboelectric sensors, and review the pressure sensors based on conjugated polymer nanocomposites that were reported in recent years. After that, we introduce the performance characteristics of flexible sensors, regarding their applications in healthcare, human motion monitoring, electronic skin, wearable devices, and artificial intelligence. In addition, we summarize and compare the performances of conjugated polymer nanocomposite-based pressure sensors that were reported in recent years. Finally, we summarize the challenges and future directions of conjugated polymer nanocomposite-based sensors.

Transfer-Tattoo-Like Cell-Sheet Delivery Induced by Interfacial Cell Migration

A direct transfer of a cell sheet from a culture surface to a target tissue is introduced. Commercially available, flexible parylene is used as the culture surface, and it is proposed that the UV-treated parylene offers adequate and intermediate levels of cell adhesiveness for both the stable cell attachment during culture and for the efficient cell transfer to a target surface. The versatility of this cell-transfer process is demonstrated with various cell types, including MRC-5, HDFn, HULEC-5a, MC3T3-E1, A549, C2C12 cells, and MDCK-II cells. The novel cell-sheet engineering is based on a mechanism of interfacial cell migration between two surfaces with different adhesion preferences. Monitoring of cytoskeletal dynamics and drug treatments during the cell-transfer process reveals that the interfacial cell migration occurs by utilizing the existing transmembrane proteins on the cell surface to bind to the targeted surface. The re-establishment and reversal of cell polarity after the transfer process are also identified. Its unique capabilities of 3D multilayer stacking, freeform design, and curved surface application are demonstrated. Finally, the therapeutic potential of the cell-sheet delivery system is demonstrated by applying it to cutaneous wound healing and skin-tissue regeneration in mice models.

The Soft-Strain Effect Enabled High-Performance Flexible Pressure Sensor and Its Application in Monitoring Pulse Waves

Flexible and wearable pressure sensors attached to human skin are effective and convenient in accurate and real-time tracking of various physiological signals for disease diagnosis and health assessment. Conventional flexible pressure sensors are constructed using compressible dielectric or conductive layers, which are electrically sensitive to external mechanical stimulation. However, saturated deformation under large compression significantly restrains the detection range and sensitivity of such sensors. Here, we report a novel type of flexible pressure sensor to overcome the compression saturation of the sensing layer by soft-strain effect, enabling an ultra-high sensitivity of ~636 kPa-1 and a wide detection range from 0.1 kPa to 56 kPa. In addition, the cyclic loading-unloading test reveals the excellent stability of the sensor, which maintains its signal detection after 10,000 cycles of 10 kPa compression. The sensor is capable of monitoring arterial pulse waves from both deep tissue and distal parts, such as digital arteries and dorsal pedal arteries, which can be used for blood pressure estimation by pulse transit time at the same artery branch.

Nonpatterned Soft Piezoresistive Films with Filamentous Conduction Paths for Mimicking Multiple-Resolution Receptors of Human Skin

Soft pressure sensors play key roles as input devices of electronic skin (E-skin) to imitate real human skin. For efficient data acquisition according to stimulus types such as detailed pressure images or macroscopic strength of stimuli, soft pressure sensors can have variable spatial resolution, just like the uneven spatial distribution of pressure-sensing receptors on the human body. However, previous methods on soft pressure sensors cannot achieve such tunability of spatial resolution because their sensor materials and read-out electrodes need to be elaborately patterned for a specific sensor density. Here, we report a universal soft pressure-sensitive platform based on anisotropically self-assembled ferromagnetic particles embedded in elastomer matrices whose spatial resolution can be facilely tuned. Various spatial densities of pressure-sensing receptors of human body parts can be implemented by simply sandwiching the film between soft electrodes with different pitches. Since the anisotropically aligned nickel particles form independent filamentous conductive paths, the pressure sensors show spatial sensing ability without crosstalk, whose spatial resolution up to 100 dpi can be achieved from a single platform. The sensor array shows a wide dynamic range capable of detecting various pressure levels, such as liquid drops (∼30 Pa) and plantar (∼300 kPa) pressures. Our universal soft pressure-sensing platform would be a key enabling technology for actually imitating the receptor systems of human skin in robot and biomedical applications.

Biomechanical Sensing Systems for Cardiac Activity Monitoring

Cardiovascular disease is consistently ranked high among the causes of death on a global scale. Monitoring of cardiovascular signs throughout the course of a long period of time and in real time is necessary in order to discover anomalies and begin early intervention at the appropriate time. To this purpose, a significant amount of interest among researchers has been directed toward the creation of flexible sensors that may be worn or implanted and are capable of constant, immediate observation of a variety of main physiological indicators. The real-time readings of the heart and arteries' pressure fluctuations can be reflected directly by mechanical sensors, which are one of the many types of sensors. Potential benefits of mechanical sensors include excellent accuracy and considerable versatility. Capacitive, piezoresistive, piezoelectric, and triboelectric principles are the foundations of the four types of mechanical sensors that are discussed in this article as recent developments for the purpose of monitoring the cardiovascular system. The biomechanical systems that are present in the cardiovascular system are then detailed, along with their monitoring, and this includes blood and endocardial pressure, pulse wave, and heart rhythm. In conclusion, we examine the usefulness of the use of continuous health monitoring for the treatment of vascular disease and highlight the difficulties associated with its translation into clinical practice.

Development of Pressure Sensor Based Wearable Pulse Detection Device for Radial Pulse Monitoring

Wearable pulse detection devices can be used for daily human healthcare monitoring; however, the relatively poor flexibility and low sensitivity of the pulse detection devices are hindering the scrutiny of pulse information during pulse diagnosis of different pulse positions. This paper developed a novel and wearable pulse detection device based on three flexible pressure sensors using synthetic graphene and silver composites as the pressure sensing material. The structural design of the pulse detection device is firstly presented; the core component of pressure sensors is using the sawtooth protrusions to convert pressure induced by radial pulse vibrations into localized deformation of graphene composites. The fabricated pulse detection device is characterized by high pressure sensing performance, including relatively high sensitivity (8.65% kPa^-1), broad sensing range (12 kPa), and good dynamic response with a response time of about 100 ms. Then, the pulse detection device is worn on a human wrist to detect the pulses from three pulse positions, namely, 'Cun', 'Guan', and 'Chi', and the results demonstrated the capability of using our device to detect pulse signals. The physical conditions of the subject, such as arterial stiffness index, can be further analyzed through the characteristics of the acquired pulse signals, demonstrating the potential application of using wearable pulse detection devices for human health monitoring.

Multimodal Finger Pulse Wave Sensing: Comparison of Forcecardiography and Photoplethysmography Sensors

Pulse waves (PWs) are mechanical waves that propagate from the ventricles through the whole vascular system as brisk enlargements of the blood vessels' lumens, caused by sudden increases in local blood pressure. Photoplethysmography (PPG) is one of the most widespread techniques employed for PW sensing due to its ability to measure blood oxygen saturation. Other sensors and techniques have been proposed to record PWs, and include applanation tonometers, piezoelectric sensors, force sensors of different kinds, and accelerometers. The performances of these sensors have been analyzed individually, and their results have been found not to be in good agreement (e.g., in terms of PW morphology and the physiological parameters extracted). Such a comparison has led to a deeper comprehension of their strengths and weaknesses, and ultimately, to the consideration that a multimodal approach accomplished via sensor fusion would lead to a more robust, reliable, and potentially more informative methodology for PW monitoring. However, apart from various multichannel and multi-site systems proposed in the literature, no true multimodal sensors for PW recording have been proposed yet that acquire PW signals simultaneously from the same measurement site. In this study, a true multimodal PW sensor is presented, which was obtained by integrating a piezoelectric forcecardiography (FCG) sensor and a PPG sensor, thus enabling simultaneous mechanical-optical measurements of PWs from the same site on the body. The novel sensor performance was assessed by measuring the finger PWs of five healthy subjects at rest. The preliminary results of this study showed, for the first time, that a delay exists between the PWs recorded simultaneously by the PPG and FCG sensors. Despite such a delay, the pulse waveforms acquired by the PPG and FCG sensors, along with their first and second derivatives, had very high normalized cross-correlation indices in excess of 0.98. Six well-established morphological parameters of the PWs were compared via linear regression, correlation, and Bland-Altman analyses, which showed that some of these parameters were not in good agreement for all subjects. The preliminary results of this proof-of-concept study must be confirmed in a much larger cohort of subjects. Further investigation is also necessary to shed light on the physical origin of the observed delay between optical and mechanical PW signals. This research paves the way for the development of true multimodal, wearable, integrated sensors and for potential sensor fusion approaches to improve the performance of PW monitoring at various body sites.

Mechanical Sensors for Cardiovascular Monitoring: From Battery-Powered to Self-Powered

Cardiovascular disease is one of the leading causes of death worldwide. Long-term and real-time monitoring of cardiovascular indicators is required to detect abnormalities and conduct early intervention in time. To this end, the development of flexible wearable/implantable sensors for real-time monitoring of various vital signs has aroused extensive interest among researchers. Among the different kinds of sensors, mechanical sensors can reflect the direct information of pressure fluctuations in the cardiovascular system with the advantages of high sensitivity and suitable flexibility. Herein, we first introduce the recent advances of four kinds of mechanical sensors for cardiovascular system monitoring, based on capacitive, piezoresistive, piezoelectric, and triboelectric principles. Then, the physio-mechanical mechanisms in the cardiovascular system and their monitoring are described, including pulse wave, blood pressure, heart rhythm, endocardial pressure, etc. Finally, we emphasize the importance of real-time physiological monitoring in the treatment of cardiovascular disease and discuss its challenges in clinical translation.

Fully inkjet-printed flexible organic voltage inverters as a basic component in digital NOT gates

In relation to conventional vacuum-based processing techniques inkjet printing enables upscaling fabrication of basic electronic elements, such as transistors and diodes. We present the fully inkjet printed flexible electronic circuits, including organic voltage inverter which can work as a NOT logic gate. For this purpose the special ink compositions were formulated to preparation of gate dielectric layer containing poly (4-vinylphenol) and of the semiconductor layer poly[2,5-(2-octyldodecyl)-3,6-diketopyrrolopyrrole-alt-5,5-(2,5-di(thien-2-yl)thieno [3,2-b]thiophene)]. A printed photoxidized poly (3-hexyltiophene) semiconductor was used as the active layer of the resistors. The operation of the printed inverters and NOT logic gates was analyzed based on the DC current-voltage characteristics of the devices. The resistance of the devices to atmospheric air was also tested. Not encapsulated samples stored for three years under ambient conditions. Followed by annealing to remove moisture showed unchanged electrical parameters in comparison to freshly printed samples.

Printable inks and deformable electronic array devices

Deformable printed electronic array devices are expected to revolutionize next-generation electronics. However, although remarkable technological advances in printable inks and deformable electronic array devices have recently been achieved, technical challenges remain to commercialize these technologies. In this review article a brief introduction to printing methods highlighting significant research studies on ink formation for conductors, semiconductors, and insulators is provided, and the structural design and successful printing strategies of deformable electronic array devices are described. Successful device demonstrations are presented in the applications of passive- and active-matrix array devices. Finally, perspectives and technological challenges to be achieved are pointed out to print practically available deformable devices.

Highly Sensitive Temperature-Pressure Bimodal Aerogel with Stimulus Discriminability for Human Physiological Monitoring

Multimodal sensor with high sensitivity, accurate sensing resolution, and stimuli discriminability is very desirable for human physiological state monitoring. A dual-sensing aerogel is fabricated with independent pyro-piezoresistive behavior by leveraging MXene and semicrystalline polymer to assemble shrinkable nanochannel structures inside multilevel cellular walls of aerogel for discriminable temperature and pressure sensing. The shrinkable nanochannels, controlled by the melt flow-triggered volume change of semicrystalline polymer, act as thermoresponsive conductive channels to endow the pyroresistive aerogel with negative temperature coefficient of resistance of -10.0% °C^-1 and high accuracy within 0.2 °C in human physiological temperature range of 30-40 °C. The flexible cellular walls, working as pressure-responsive conductive channels, enable the piezoresistive aerogel to exhibit a pressure sensitivity up to 777 kPa^-1 with a detectable pressure limit of 0.05 Pa. The pyro-piezoresistive aerogel can detect the temperature-dependent characteristics of pulse pressure waveforms from artery vessels under different human body temperature states.